肺「毛細管」壓に關する研究(第3報) : 急性肺浮腫と楔入壓
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Among the various causes for the development of the pulmonary edema, the most important one seemed to be the rise of the hydrostatic pressure level around the pulmonary capillaries. The minimum of the hydrostatic level which leads to the pulmonary edema has been discussed, and it is believed that it would be differently effected by some other causes.Tetraethylammonium bromide (TEAB) has been supposed to get the pulmonary artery pressure fall and restrain the heart in its function. But I will report here on my own experience in which I clinically observed the pulmonary edema with the remarked pulmonary hypertension. It was caused quite unexpectedly, when I injected 200 mg of TEAB into muscles while the catheter was inserted into the pulmonary artery.The first cases was a patient with aortic insufficiency and the second case was that of essential hypertension. The both cases showed clinically pulmonary edema in 3 to 5 minutes after TEAB injection. WP of the first case was 27 mmHg and mean pulmonary artery pressure was 42.5 mmHg before injection. while on the other hand WP was 35 mmHg and pulmonary artery pressure was 57 mmHg during fit. By removal of catheter and squating in Japanese fashion, fit was dettered. WP of the second case was 9 mmHg and the mean pulmonary artery pressure was 21.5 mmHg before injection, while on the other hand WP was 33 mmHg and pulmonary artery pressure was 54.5 mmHg during fit. In this case the injection of Theophyllin Etylendiamine 250 mg intravenously caused the fall of WP and at the same time the case was bettered. In both cases, In observed that in accordance with WP elevation, the pressure gradient between the pulmonary artery pressure and WP showed the tendency to increase. I can not explain the rising cause of pulmonary blood pressure after TEAB injection. The rising of WP means the rising of the pulmonary small vein pressure.When WP was elevated up to more than a certain level, the pulmonary edema was observed to develope rapidly.According to the elevation of WP, pressure gradient between pulmonary artery pressure and WP increased. This should be reduced to the increase of resistance on the pulmonary small artery, which is believed to be the protecting reaction against the pulmonary edema.
- 社団法人日本循環器学会の論文
- 1956-12-20